As towns save, workers fear health care hikes

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Communities south of Boston are getting ready to cut their health insurance costs, but public employees worry the savings will ultimately come out of their pockets.

Pembroke and Marshfield are among those that have adopted a 2011 municipal health insurance law that allows local governments to change workers’ deductibles and copayments outside the collective bargaining process.

Unions participate, but if they cannot agree, the matter goes to a three-member panel, with one representative from a union, one from the city or town government, and a third member both parties select from nominations made by the state secretary of administration and finance.

In essence, “instead of the union having binding arbitration, management has it,’’ said Edwin Thorne, town administrator in Pembroke.

Marshfield adopted the law Dec. 5, Pembroke a week earlier. Plymouth has adopted a portion of the law, but not all of it.

Marshfield Town Administrator Rocco Longo said his community is cooperating with Rockland and several other towns, members of a joint purchasing group called the Mayflower Municipal Health Group, to hire a consultant to help them navigate the process, although not all the towns have adopted the law. Statewide, more than 20 communities have adopted it.

Proponents say the law will reduce premiums by bringing deductibles and copays more in line with the private sector. Since both workers and taxpayers contribute to premiums, both could save money. Union representatives and some elected officials, however, worry that higher deductibles and copays could equal or exceed workers’ savings in premiums.

“I’m really concerned about some of our lower-earning employees,’’ said John Hall, chairman of the Marshfield Board of Selectmen.

Sarah Marples, president of the Marshfield Education Association, agreed with Hall, saying the union is focused on the overall cost to its members, and particularly those earning lower salaries, such as support and clerical staff. She was pleased to hear the selectmen’s remarks on Monday.

“At this point, we’ll take them at their word and move forward collaboratively,’’ she said. “We know the town needs to save money, and so do our members.’’

Plymouth adopted the law except for the section that allows the town to transfer its employees into the state’s Group Insurance Commission.

Plymouth, which is self insured, could not legally force employees into a commission plan, said Town Manager Mark Stankiewicz, because the most widely subscribed commission plan did not represent a 5 percent savings over the town’s other options.

Skeptics about the law’s ability to produce savings include Plymouth County Treasurer Thomas O’Brien, who serves as treasurer of the Mayflower Municipal Health Group.

O’Brien said health plans like those offered by the Group Insurance Commission may save money for large cities, but the 31 towns and other government entities that belong to Mayflower would probably do better with what they have.

He said Mayflower has contained costs, achieving an average premium increase of 6.8 percent over the last four years. Moreover, towns that adopt the law restrict what elements of their health plans they can change, he said, whereas those that do not can renegotiate with unions more freely.

Publicity surrounding the law “held it out as an ephemeral pot of gold at the end of the rainbow,’’ he said, but it does nothing to reduce the price of health care. Thus, O’Brien said, any savings on the part of taxpayers shifts the cost to employees.

“That’s definite,’’ he said. “There’s nothing else they can do.’’

Municipalities that adopt the law and change their deductibles and copays can remain part of Mayflower unless they join the Group Insurance Commission.

Abington, Bridgewater, Halifax, Hanover, Hanson, Hingham, Hull, Kingston, Marshfield, Norwell, Pembroke, Plympton, Rochester, Rockland, Scituate, West Bridgewater, and Whitman are members of the Mayflower group, as is the Brockton Area Transit Authority. Employees in Bristol, Norfolk, and Plymouth counties get their insurance through Mayflower as well.

Towns that adopt the health insurance law are not required to change their plans, according to Thorne, the Pembroke town administrator. If they prefer the existing terms, they can keep them.

Pembroke’s next step is to meet with an insurance advisory committee composed of union representatives, then wait until January for Mayflower to present its rates for next year.

O’Brien predicted Pembroke would have to wait longer to get rates from the Group Insurance Commission for comparison.

“Next year our rates are probably going to be lower than the GIC,’’ he said, so he is not worried about towns leaving Mayflower. “We’ve got them lined up to join.’’

In Marshfield, though, the town administrator said premiums have increased an average of 11 percent a year over the last decade.

“I’m happy the board voted this, because we have an obligation to the public to do the best we’re able to do,’’ he said.

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